CDC Telebriefing: Arthritis in America

OPERATOR: Welcome and thank you for standing by. All participants will be in listen-only mode until the Q&A session. At that time you may press star 1 to ask a question. Today’s conference is being recorded, if you have any objections you may disconnect at this time. I will now turn the meeting over to Kathy Harben. Thank you. You may begin.

KATHY HARBEN: Thank you. Good afternoon everyone. This is Kathy Harben, Chief of CDC’s News Media Branch. Thank you Melinda and thank you everyone for joining us today – for the release of a new CDC Vital Signs. This one is on Arthritis in America. We’re joined today by the Acting Director of CDC, Dr. Anne Schuchat, Dr. Kamil Barbour and Dr. Chad Helmick. They’re epidemiologists in our CDC arthritis program. I’ll now turn the call over to Dr. Schuchat for opening remarks.

DR. ANNE SCHUCHAT: Thanks so much for joining the call. CDC works 24/7 to protect the health, safety, and security of all Americans. One of the ways we do this is by identifying health threats and working to address them. This Vital Signs report contains important information about the growing health problem of arthritis. Everyone knows someone with arthritis – family members, friends, and neighbors. The news is this: Arthritis is at an all-time high. More than 54 million people report a diagnosis of it. Alarmingly, more people with arthritis are suffering from it. Among adults with arthritis, the percentage whose lives are particularly limited, has increased by about 20 percent since 2002. From about 36 percent in 2002 to 43 percent in 2015. We are seeing this increase independent of aging of the population. When I say limited, I mean that adults may not be able to kneel on the ground, hold a cup, lift a grocery bag, or walk to their car. Today’s Vital Signs report finds that 24 million adult American lives are limited because of their condition. Dealing with limited abilities can be frustrating and have a negative impact on the quality of life. In particular, African Americans and Hispanics with arthritis are more limited in their daily activities. For this Vital Signs, CDC analyzed data from the National Health Interview Survey, examining the health status of those diagnosed with arthritis. The sample involved over 100,000 respondents who were interviewed between 2013 and 2015. Arthritis affects about 1 in 4 adults in America and as the U.S. population grows and ages, we estimate there will be 78 million adults with arthritis by 2040. This is not your mother’s arthritis. Contrary to popular opinion, arthritis is not an old person’s disease. About 60 percent (six – zero) of all adults with arthritis are less than 65 years old. We know that working age adults with arthritis have lower employment than those without arthritis.

While it may seem counterintuitive, physical activity can be the antidote for many people. Physical activity can actually decrease pain and improve function by almost 40 percent.

The bottom line is that arthritis is impacting the lives of millions of Americans every day. It’s at all-time high, with many unable to go about their daily routines because of their symptoms – limiting abilities of significantly more adults than a decade ago. What can we do about this? While it may seem counterintuitive, physical activity can be the antidote for many people. Physical activity can actually decrease pain and improve function by almost 40 percent. But many are not physically active. Right now, about 1 in 3 adults with arthritis report being inactive. In the past, people with arthritis may have been told not to be active in fear of making their arthritis worse. It’s now proven that being physically active can be helpful and there are ways to be active that can accommodate physical limitations from arthritis. We want people to know it’s best to address their arthritis before symptoms become more severe. By taking action now you can help improve your everyday life. The Vital Signs report points to ways to ease arthritis pain without medicine. Adults with arthritis experience pain, aching, stiffness and swelling of the joints. Many adults with arthritis are prescribed opioids. However, there are safer options for arthritis associated pain to include exercise and more movement. The discomfort from arthritis leaves many people thinking they can’t do some exercise, but that’s exactly what they need to do. Adults with arthritis can try walking, biking, swimming or participating in physical activity programs available in parks and recreation centers, YMCAs, and other community based organizations across the U.S. There’s a phrase I recently heard that says it all. “Rest is rust, motion is lotion”. By this we mean that being more physically active can actually help grease those joints to ease pain and increase movement. We know that physical activity is not the only solution to controlling arthritis.

The Vital Signs report also points to proven disease management education programs as a way to ease arthritis pain. Men and women with arthritis can reduce their symptoms by 10 to 20 percent by participating in disease management education programs, to acquire skills to better manage their symptoms. Right now, these classes are reaching only 1 in 10 people with arthritis. The classes are available in many community settings. We know that adults with arthritis are significantly more likely to attend a disease management education program when a healthcare provider recommends it to them. That’s why we are calling on doctors and other healthcare providers to promote physical activity and disease management education programs to adults with arthritis. During patient visits, we are asking providers to urge patients with arthritis to increase physical activity and strive for a healthier weight to ease joint pain, recommend patients attend proven education programs to learn about managing their condition and consult the guidelines of the American College of Rheumatology or other professional organizations for treatment options.

We have found that one third of adults with arthritis over age 45 report anxiety or depression.

We are also asking for doctors and other providers to ask patients about any depression or anxiety, and offer care, treatment, and links to services. We have found that one third of adults with arthritis over age 45 report anxiety or depression. Beyond the suffering of many millions who have arthritis, the condition is also costly to America. Direct medical costs for arthritis are $81 billion a year. There are 1 million total hip and knee replacements each year. Almost all of those are to improve arthritis related pain and function.

The Vital Signs analysis also emphasized the link between arthritis and other chronic diseases. About half of all adults with heart disease or diabetes had arthritis. Nearly 1 in 3 adults who were obese also had arthritis. This is particularly concerning because those with heart disease, diabetes, and obesity should be physically active to help manage their conditions. Those with arthritis might be more reluctant to do so due to pain, or fear of pain, or not knowing what exercise is safe for their joints.

Here’s the bottom-line. I understand that arthritis pain can be debilitating and have a major impact on quality of life. When you’re in pain, exercise is often the last thing you want to do. Start small, by taking a short walk in the park, gardening or a lap in the pool. This can start patterns that can make a big difference in the long run. Working with your doctor and family to learn what helps you can go a long way towards improving your physical and mental health. I’ll turn things back over to the moderator now.

KATHY HARBEN: Thank you Dr. Schuchat. Melinda, we are ready for questions. First I want to introduce our scientific experts who are with us today – Dr. Kamil Barbour and Dr. Chad Helmick. They are available to take questions as well.

OPERATOR: Thank you. At this time to ask a question, please press star one. Please unmute your phone and clearly record your name when prompted. To withdraw your request, please press star 2. One moment please for any questions. The first question is from Mike Stobbe – Associated Press. Your Line is now open.

MIKE STOBBE: Hi. Thank you for taking my question. I have two questions actually. CDC had a similar report about 7 years ago. The report said about 22 percent of the adult population had doctor diagnosed arthritis – says 22.7 percent. I know the number increased but was there a significant change in the proportion of adults that have doctor diagnosed arthritis? My second question had to deal with what Dr. Schuchat was talking about – in terms of the percentages of people with arthritis who had severe limitations that was increasing. It looked like it was significant. Could you say a little bit more about why that may be? Is there a co-factor like obesity or what might explain that increase?

DR. ANNE SCHUCHAT: Thanks so much Mike for your questions. The percentage of adults who have arthritis did not change significantly. The numbers went up because the population has grown and aged. But what did go up significantly is the percentage of those with arthritis who have severe limitations. As we mentioned that went up about 20 percent since 2002 – adjusted for age which is a significant increase. I think that co-factors are a likely explanation. We haven’t done all of the analysis but factors like obesity have been increasing in the general population and we know that arthritis can be more severe in people suffering from obesity. So, I think that’s a likely explanation. Thanks.

Next question.

OPERATOR: Next question from David Beasley, Reuters News. Your line is open.

DAVID BEASLEY: Yes, I would just like to follow up on that last question by mentioning exercise. Is there any indication that people are exercising less than they did 10-15 years ago? Is that could be a factor of more disabilities?

DR. ANNE SCHUCHAT: You know that information I don’t have. I think that there are additional analyses to do. But I do want to stress that we know people who have arthritis are often scared of exercising – they think it might make their symptoms worst. There are now multiple randomized control trials that suggest that physical activity can significantly improve function and pain. It can improve symptoms by about 40 percent in the various studies that have been conducted. So, we do think that increasing physical activity, even if you’re are suffering from arthritis is a good idea.

Next question.

OPERATOR: Currently no questions. As a reminder please press star 1 to ask a question. One moment please. We’re showing no questions at this time.

KATHY HARBEN: Thanks everyone. I want thank Dr. Schuchat, Barbour and Helmick for joining us today and also a big thank you to the reporters. For follow up questions, you can call the CDC Press Office at 404-639-3286 or email us at [email protected]. Thank you for joining us. This concludes are call.

OPERATOR: Thank you for attending today’s presentation this does conclude the conference. You may disconnect at this time.